Four-day lansoprazole-quadruple therapy in the routine treatment of Helicobacter pylori infection

Background: Ulcer patients need to be treated for Helicobacter pylori infection. Seven days of quadruple therapy achieves the highest cure rates. In this study a 4-day quadruple regimen of lansoprazole, bismuth, tetracycline and metronidazole is investigated. Methods: in an open study 66 consecutive infected patients with ulcer disease or non-ulcer dyspepsia were treated with 4-day quadruple therapy after 3 days of lansoprazole pretreatment. PI. pylori status was determined before and at least 6 weeks after therapy by endoscopy with antral and corpus biopsies for rapid urease test, histology and culture. Results: Sixty-four patients took the medication and complete compliance was achieved in 60 (94%). Tolerability was excellent and there were no drop-outs due to side-effects. Overall 55 out of 64 (86%, 95% CI 77.4-94.4%) were cured, including 41/44 with a metronidazole-sensitive strain and 5/8 with a resistant strain. Conclusions: Four-day quadruple therapy is well tolerated and very effective especially in metronidazole-sensitive strains. This study lends further support for the use of one-week quadruple therapy as empiric first line anti-Helicobacter therapy for Dutch ulcer patients. if patients suffer from side-effects during this therapy stopping treatment at day 3 can be advised. (C) 1998 Elsevier Science B.V.